Doctors, Patients, Answer the Call!

My first paycheck as a fresh out of medical school M.D. came from the VA. I performed my first “solo flight” cataract operation on a trusting veteran at the Audie Murphy VA Hospital- talk about a brave soldier. He and I developed a patient-physician relationship over a year, and by the time he was in need of vision restoring surgery, he wanted only me to do it, and I didn’t want anyone else to operate on my beloved patient. I had been training for this rite of passage since I could pray. I was ready. He was proud and honored to volunteer to be my first complete operation-at least that’s what he told me, and that’s what I believed. He had been a pilot and told me about his first solo flight as well as many other stories of his experiences in World War II. He instilled confidence in me, and we shared an unspoken trust and sacred bond like no other. That’s what the Hippocratic patient-physician relationship is. I prayed harder, humbled and aware of my own frailty. The surgery went flawlessly, and I was off on my medical journey, a surgical career now spanning twenty years, 10,000 cases, and tens of thousands of patients.

My father overcame poverty through hard work and education to become a pioneering neurosurgeon and the first chairman of neurosurgery at the University of Texas Medical School at San Antonio. He operated at the VA hospital for 30 years, devoting his life to giving veterans state-of-the art, highest quality, compassionate, dignified, individualized neurosurgical care while training some of the finest neurosurgeons in the United States. His brothers were both WWII veterans, and both were lifelong patients of the Audie Murphy VA Hospital. These three brothers provided and received the best of the best there, in the fashion of WWII hero, Audie Murphy himself.

After five years in academic medicine and nine years on the VA/UT payroll, I set off into private practice. I continue to care for veterans. I am blessed and honored to care for Generals, Colonels, Sergeants, and Seals each day. One of my patients was even a Tuskegee Airman. If you stop, listen, and examine each individual patient, you will learn so much. You will also find the diagnosis and treatment they seek. Such a process does not come from administrators, computers, or a 2700 page law; it comes from hands-on, secure, heartfelt personal interaction between the highly-trusting patient and the highly-trained Hippocratic physician.

Enter government medicine with its perverse incentives, impersonal bureaucratic waste, and anti-Hippocratic, pro-statist mentality- this is where we are. Is this what we trust?

A few weeks ago, a friend called me, worried sick about his father, a veteran, who had left the Audie Murphy AMA (against medical advice) the day before. I said “bring him to my office now”. The patient-veteran reported he had been admitted for stroke symptoms to an under-renovation room of six men, where he sat for three days with little to no evaluation or interaction with medical personnel, waiting for promised tests and treatment. He walked out.

That same day a patient, a VA nurse, related concerns about current attitudes and conditions at the VA and that she was retiring. She said the Audie Murphy museum had been disassembled, his revered belongings offered back to his family, in the name of renovation. This memorial, which had graced the entrance to the hospital, inspiring thousands for years, a hallowed reminder of sacrifice, heroism, courage, and exceptionalism, is now being transformed into administrative offices. How symbolic. How fundamentally frightening.

Then a few days later, news of the institutional, inhumane VA crisis breaks. We discover that our precious, courageous veterans are not only being denied access to the VA, but that across the nation thousands are being placed on dead-end waiting lists to potentially die at the hand of government employed administrators seeking bonuses at the expense of saving lives. These government employees, who have never taken the Hippocratic Oath, are paid by the same hand that dismantles the memorial to self-sacrificing Audie Murphy to erect offices for self-serving government bureaucracy. We say “No More”!

Who assigned our veterans to the Real vs. the Secret list? Were there established criteria like age, union membership, or certain diagnoses from top down? Were there payoffs? Was it reward vs. penalization? Or was it just luck of the draw and mood of the scheduler that day? Whatever it was, we need to know. Bonuses based on waiting list times instead of number of patients served are perverse. Perverse leaders/bosses believe “ends justify the means” and tend to recruit like-minded followers/employees, who, lock in step, shorten the waiting list to get the bonus. What is the goal- incentivizing employees to ration scarce medical resources by any means or actually caring for patients by allocating scarce resources to patient-care instead of bonuses?

The Obamacare architects and healthcare advisors our Commander-in-Chief surrounds himself with do not like the Hippocratic Oath. They believe it is too costly, outdated, and that the government needs to intervene between the patient and physician. They believe in the collectivist philosophy of Plato, where the individual’s duty is to the state. At some point you’ve used up enough resources; at some point you’ve lived enough life. They seek socialized medicine. They revere Saul Alinsky, his relative truth, and his “ends justify the means” tactics. See for yourself. Read Rules for Radicals. Read the writings of Ezekiel Emanuel, MD, Obamacare architect, Presidential advisor, member of The Federal Coordinating Council of Comparative Effectiveness Research (“The Council”, established 2009 in the Stimulus Bill, Obamacare phase one), and creator of The Complete Lives System as described in his article “Principles for allocation of scarce medical interventions”, (www.thelancet.com Vol 373 January 31, 2009) . Healthcare law crafted by those who espouse such perverse ideology, enforced by a system of perverse incentives, results in perverse outcome and loss of human dignity and life. This is not what our veterans fought for. This is not what we can stand blindly by and accept.

One by one, we must each individually do what big government can’t and won’t. Whatever you can do, do it now. Our veterans laid their lives on the line for us; now we must lay our lives on the line for them. This is our “red line”. The American people value life and human dignity. We are a loving, brave, virtuous, ethical people. We value the Hippocratic Oath. We are not like Emanuel, and we do not believe in statist medicine where at some point it is our civic duty to die. We are a government of, by, and for the people, whose miraculous Constitution created the freest people in the history of the world, and whose free-minded people created the most amazing, life-extending, life-saving, medical advances in the world. We believe in absolute Truth. Our Constitution empowers us and calls for us to secure the Blessings of Liberty to ourselves and our posterity. Answer the call.

Kris Held MD is an ophthalmologist in private practice. You can follow Dr. Held on Twitter@kksheld